Genital basal cell carcinoma, a different pathogenesis from sun-exposed basal cell carcinoma? A case-control study of 30 cases

Pigmented nonmelanoma skin cancers of the genital area: a diagnostic and therapeutic challenge - monocentric experience and review of the literature

Nonmelanoma skin cancers (NMSC), comprising basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), are typically encountered on photo-exposed skin. Nevertheless, several cases of NMSC have been described in covered areas such as the genital region; furthermore, some of these lesions may express a variable degree of pigmentation. Due to the existence of mucosal melanoma, an accurate diagnosis is paramount. In this narrative review, we focused our attention on management and - in particular- diagnosis of pigmented NMSC (pNMSC) located in the genital region, emphasizing the features assessed by dermoscopy and reflectance confocal microscopy. As an implementation, we included data on pNMSC from the Dermatology Unit of the University of Campania Vanvitelli. BCC in the genital region represents only 1% of all BCC cases. It has been supposed that the mutation of patched 1 may lead to the development of BCC even without concomitant UV exposure. Pigmented variants on genitals have seldom been described. More prominent dermoscopic features seem to be blue-gray ovoid nests and arborizing vessels associated with whitish structureless areas. SCC and Bowen's disease (BD) - a variant of in situ SCC - may be encountered in the genital area and are sometimes associated with human papillomavirus (HPV) infection. Pigmented SCC is very rare, and most of the literature is focused on pigmented BD (pBD), which is mainly characterized by gray-brown dots in a linear fashion and glomerular vessels without evident scales. In conclusion, pNMSC is rarely encountered on genitals; evaluation with dermoscopy or other ancillary devices like RCM is important both to exclude benign lesions like seborrheic keratosis and lentigo and to rule out melanoma.

Cutaneous Malignancies of the Head and Neck

Cutaneous malignancies (CMs), or skin cancers, are the most common cancer worldwide, with a quarter million cases diagnosed annually in the United States alone. The best described risk factor for CM is ultraviolet radiation from sunlight, and therefore most of these cancers develop in sun-exposed skin, including the head and neck. Beginning with melanoma, immunotherapy has increasingly been used over the past decade for treatment of unresectable CM, and immune checkpoint inhibitors are now Food and Drug Administration-approved for first-line treatment of unresectable melanoma, Merkel cell carcinoma, and cutaneous squamous cell carcinoma, and second-line for basal cell carcinoma.

[Vulvar intraepithelial neoplasias]

Vulvar squamous cell carcinoma arises from precursor lesions: vulvar intraepithelial neoplasias (VIN). Most of them are caused by the human papillomavirus (HPV), and the precursor lesion for this group is VIN usual type/high grade squamous intraepithelial lesion (uVIN/HSIL) of variable clinical presentation and having a light invasive potential. Some VIN are HPV-independent and arise in older women against the background of chronic dermatoses, mostly lichen sclerosus. Their histological diagnosis is more subtle. They have a higher invasive potential. A third precursor, leading to well-differentiated, or even verrucous, carcinomas, is still ill-defined to this day. We detail these lesions' clinics, histology, and biomarkers (immunohistochemical and molecular).

Metastatic basal cell carcinoma with atypical pattern of spread

Basal cell carcinoma is the most common malignancy in the United States. However, metastasis of basal cell carcinoma is exceedingly rare, with incidence estimates of 0.0028-0.055%. When it does metastasize, basal cell carcinoma most commonly spreads to regional lymph nodes and lungs, although other sites of disease can occur. This case report presents multi-modality imaging of a 54-year-old male who developed multifocal metastatic basal cell carcinoma approximately three years after initial presentation with an ulcerated groin lesion. Ultimately, metastases included many common and uncommon sites, including lymph nodes, lung, duodenum, spleen, and adrenal glands. This case provides an interesting example of an uncommon pattern of spread and associated symptoms of treatment-resistant metastatic basal cell carcinoma.

Trichoblastomas Mimicking Basal Cell Carcinoma: The Importance of Identification and Differentiation

Trichoblastoma is a rare, slow-growing, benign cutaneous tumor derived from follicular germinative cells. Trichoblastoma commonly appears as an asymptomatic, symmetrical, well-circumscribed, skin-colored to brown or blue-black papule or nodule. It may appear clinically and histologically similar to basal cell carcinoma, making its diagnosis challenging. Even on dermoscopy, it is challenging to differentiate trichoblastoma from basal cell carcinoma. In practice, it is important to differentiate the two, because the choice of treatment and resulting prognosis differ between the lesions. Surgical biopsy to analyze histopathological and immunohistochemical differences is the gold standard for diagnosing and differentiating trichoblastoma from basal cell carcinoma. Trichoblastoma typically has a favorable prognosis, with a low incidence of recurrence, progression or association with malignancy. This paper provides a review of the epidemiology, clinical presentation, dermoscopy, histology, immunochemistry, treatment, and prognosis of trichoblastoma.

Contemporary Topics in Radiation Medicine: Skin Cancer

Radiation plays an important role in the management of a variety of skin cancers. This article discusses the role of radiation in the treatment of cutaneous squamous cell carcinoma, basal cell carcinoma, Merkel cell carcinoma, cutaneous T-cell lymphoma, and B-cell lymphomas.